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As more practices consider offering telemedicine, both the big picture and the small details matter.
When patients contacted her via social media Tisha Rowe, MD, MBA, used to respond to them. But when the Houston, Texas-based primary care physician found that the messages kept coming, she knew something had to change. “A lot of people would reach out to me and say, “Can you answer this question?’” she says. “I thought, ‘Wait a minute. I’m working, and I’m not getting paid for it.”
This article appears in the 4/10/18 issue of Medical Economics.
In 2014, no one was really discussing telemedicine, she says. So she looked into implementing it not just for her own patients, but for others. Today, Rowe is the founder and CEO of RoweDocs, an online network of 75 physicians who offer telemedicine visits to their current patients.
But even with Rowe’s business background, finding the right vendor wasn’t easy. Vendors would make promises they ultimately couldn’t deliver on.
The first company had problems in following HIPAA. The second couldn’t bill an insurance company, or verify a patient’s insurance coverage. The third said it was a telemedicine company, but only offered chat communications without video conferencing, Rowe says.
As Rowe’s experience indicates, finding the right telemedicine vendor can be a challenge. As more practices consider offering telemedicine, both the big picture and the small details matter. Taking a thoughtful approach can help physicians determine which vendor will provide the best fit for their practices and their patients.
Asif Shah Mohammed, MBA, associate principal at ECG Management Consultants, a healthcare management consulting firm, first worked with Greensboro, N.C.-based Cone Health, a six-hospital healthcare system, two years ago. Cone Health contacted ECG after seeing a competitor’s highway billboards offering $50 telemedicine visits. Cone Health wanted to do something similar.
According to John Jenkins, MD, Cone Health’s senior vice president and chief clinical office for connected care, Cone had three objectives for implementing telemedicine: positioning the company as innovative and transformative, remaining competitive in a market where other companies advertised frequently about their own telemedicine capabilities, and creating a multi-year strategy for entering the digital health world.
“Spend as much time as possible defining the problem before you look for solutions-that is absolutely critical,” Jenkins advises. “People tend to jump into virtual health, as a way to check the box, rather than thinking about why they need it.”
Shah Mohammed says practices need to think about telemedicine as a concept. Know the answers to questions such as “Why do this?”, “How to do it?”, and “How will it affect your brand?” Don’t consider vendors solely by what technology they offer, but instead know what problems the practice is trying to solve with telemedicine integration, such as patient convenience, or staying competitive in the market.
Once a practice understands why it wants to implement telemedicine, Shah Mohammed notes that finding a third-party planner can help a practice select potential vendors, though it’s certainly possible for a practice to make the decision on its own. The potential to get bogged down by the number of vendors and what they offer, however, can be minimized by using an outside consultant.
Shah also cites branding as a consideration when implementing telemedicine. “It’s common to have something indicating that the system is ‘powered by XYZ vendor,’” says Shah Mohammed. Is it important for the practice to offer its own telemedicine technology directly on its own website, for example, or would the practice prefer to send its patients to a third-party website or vendor app? And if the vendor’s website or app is what the practice will use, would the patient be able to tell the difference, or will it appear as if the software comes from the practice itself?
Using its own branded telemedicine site has its advantages, notes Shah Mohammed. ”From a patient perspective, they will continue to stay within the practice’s ecosystem,” which helps keep the patient connected to the practice, indicates that the practice is innovative, and maintains the patient’s familiarity with the practice they already know, he says. It also keeps patients from potentially leaving the practice’s website and not returning.
The disadvantages of a branded site are that if the patient has a bad experience with the platform, even if it is a vendor issue, the patient will associate that experience with the practice itself, Shah Mohammed says. Other critical questions include:
If the practice is relying on smartphone apps to connect with patients, will the vendor be able to support patients who use both iPhones and Android devices?
Can the vendor work with the practice to individualize what it offers for each practice, or is it a more universal system?
How does the vendor provide training so that the practice physicians understand how the telemedicine system operates? How quickly will they offer patients access to the provider?
Without implementing feedback from patients on how telemedicine should work, it’s possible patients won’t stick around long enough to use the system for an extended period, says Shah Mohammed. His client, Cone Health, used patient feedback it obtained through surveys and follow-up phone calls to improve the process.
Ultimately, Cone Health saw more growth than all its competitors saw in the prior three years because their telemedicine vendor provided the whole experience, he says. “As a result, repeat patients would say, ‘If I hadn’t been able to do this video visit, I would have gone to the ER,’” he says.
Rowe says practices should ask vendors for a 30-day trial period, to ensure that the vendor can actually provide the services it says it can offer. Also, when a vendor offers customer support, ensure it is available during extended hours or over the weekend, “not during the time you plan on seeing patients,” she says.
Other points to consider: use a vendor with a physician support line that is separate from what patients use for support, and confirm that a vendor’s software can verify insurance, as well as send and receive prescriptions and labs directly, Rowe says.
The experience helped Rowe develop RoweDocs to serve as an implementation manager for practices who want to incorporate telemedicine.
“Don’t just try to put the tech in and think it will magically work without doing the work,” she says. “What makes each tech vendor different isn’t that much, but it’s what you do with the technology that is important.”